A Clinical Analysis of Well-Differentiated Thyroid Cancer

Kang, Wook; Jung, Sung Hoo

Abstract

BACKGROUND: Thyroid cancer is the most common endocrine malignancy, and it has a wide spectrum of biologic behavior, histologic appearance, and management. This study reviewed various aspects of the clinical features of well-differentiated thyroid cancer.
METHODS
We retrospectively reviewed the clinical characteristics of 114 patients who had undergone surgical management for well-differentiated thyroid cancer at the Chonbuk National University Hospital from September 1989 to December 1997.
RESULTS
The most prevalent age group was in the 5th decade (29 cases, 25.4%). The male-to-female ratio was 1 to 5.7. The most common initial symptom was a palpable mass on the anterior or the lateral portion of the neck (110 cases, 96.5%). The most common duration of illness from the appearance of the symptom to the treatment was below 3 months (38 cases, 34.5%). The primary tumors were located on the right lobe (49 cases, 43.0%), the left lobe (38 cases, 33.3%), both lobes (22 cases, 19.3%), and the isthmus (5 cases, 4.4%). In the histopathologic study, the common type was a papillary carcinoma (102 cases, 89.5%). The common surgical procedures were a total thyroidectomy (66 cases, 57.8%) and a near total thyroidectomy (24 cases, 21.0%). Seventy-five patients (65.8%) received a lymph-node dissection, and there was cervical lymph-node metastasis in 43 cases (57.3%) of this group. Postoperative complications occurred in 11 cases (9.3%). The common complications were hemorrhage or seroma (5 cases, 4.4%), hoarseness (5 cases, 4.4%) and wound infection (1 case, 0.9%). Although hypoparathyroidism was predicted, the predominant symptoms did not appear. Regional recurrence or distant metastases were present in 13 cases (11.4%) during four years.
CONCLUSIONS
Thyroid cancer has a wide spectrum of biological behavior and also problems including the lack of reliable prognostic factors and objective assessments of therapeutic modalities. Appropriate and aggressive management should be recommended because most of well-differentiated thyroid cancer has a favorable prognosis.